MEDICARE: EXABLATE OF LAS VEGAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1528149085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXABLATE OF LAS VEGAS

Provider Business Mailing Address
First Line	:	2 NORTHPOINT DR
Second Line	:	SUITE 950
City	:	HOUSTON
State	:	TX
Zip	:	77060-3235
Country	:	US
Telephone Number	:	281-820-7900
Fax Number	:	281-820-7925

Provider Business Practice Location Address
First Line	:	7170 SMOKE RANCH RD
Second Line	:	SUITE A
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1103
Country	:	US
Telephone Number	:	281-820-7900
Fax Number	:	281-820-7925

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	CLIFFORD KIRBY
Credential	:
Telephone Number	:	281-820-7900

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/22/2020

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Directions to “EXABLATE OF LAS VEGAS ” Practice Location

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